Cover -- Title -- Copyright -- Contents -- Contributors -- Preface -- Acknowledgments -- Share Spasticity: Diagnosis and Management, Second Edition -- Part I: General Overview -- Chapter 1: Why Is Spasticity Treatment Important? -- Chapter 2: Epidemiology of Spasticity in the Adult and Child -- Stroke -- Spinal Cord Injury -- Multiple Sclerosis -- Cerebral Palsy -- Conclusion -- References -- Chapter 3: Spasticity and Other Signs of the Upper Motor Neuron Syndrome -- Negative Signs -- Stretch-Sensitive Positive Signs -- Positive Signs That are Not Stretch Sensitive -- Maladaptive Consequences of the UMNS -- Conclusions -- References -- Chapter 4: Ancillary Findings Associated With Spasticity -- Sensory Disturbances -- Voice, Speech, and Swallowing -- Bowel and Bladder -- Sleep -- Psychosocial Issues -- Case Study -- Conclusions -- References -- Part II: Assessment Tools -- Chapter 5: Measurement Tools and Treatment Outcomes in Patients With Spasticity -- Spasticity Outcome Measures—What is a Useful Outcome Measure? -- An Organized Approach to Spasticity Outcomes -- Physiological Measures -- QOL Measures -- Choosing an Outcome Measure to Assess Intervention Effectiveness -- Types of Assessment Methods and Tools -- Measures of Voluntary Activity -- Functional Measures -- QOL Measures -- Conclusions -- References -- Chapter 6: Techniques and Scales for Measuring Spastic Paresis -- Definition of Spasticity -- Measure of Spasticity: The Ashworth and Tardieu Scales -- Definitions of Stretch-Sensitive Paresis and Spastic Cocontraction -- Assessment of the Range of Active Movement and of Its Decrement After Repeated Maximal Efforts, as Net Results of Paresis and Spastic Cocontraction -- Conclusion -- References -- Chapter 7: Assessment of Spasticity in the Upper Extremity -- Identifying Goals in Upper Extremity Assessment -- Anatomic Considerations in Assessing the Upper Extremity -- Assessment of the Shoulder -- Assessment of the Elbow -- Assessment of the Wrist -- Assessment of the Fingers -- Functional Considerations in Assessment of the Upper Extremity -- Development of the Treatment Plan to Assess Upper Extremity Spasticity -- Follow-Up Assessments of Upper Extremity Spasticity -- Summary -- References -- Chapter 8: Assessment of Lower Limb Spasticity and Other Consequences of the Upper Motor Neuron Syndrome -- Clinical Assessment of Spasticity -- Functional Assessment of Gait to Evaluate Lower Limb Dysfunction -- References -- Chapter 9: Setting Realistic and Meaningful Goals for Treatment -- Choosing Meaningful and Realistic Treatment Goals -- Determining Treatment Goals -- Goal Attainment Scale -- Conclusion: Synthesis of Information and Choosing Treatment Goals -- Case Discussions -- References -- Part III: Treatment of Spasticity -- Chapter 10: Chemoneurolysis With Phenol and Alcohol: A “Dying Art” That Merits Revival -- Chemical Neurolysis -- Phenol -- Alcohol -- Comparison of Phenol Neurolysis and BoNT -- Pediatric Considerations -- Suggested.
Approaches for Specific Upper Motor Neuron Disorders -- Conclusion -- References -- Chapter 11: Botulinum Toxin in the Treatment of Lower Limb Spasticity -- Functional Implications of Spasticity -- Clinical Assessment of Spasticity -- The Role of BoNT in the Treatment of Spasticity -- Conclusion -- References -- Chapter 12: Botulinum Toxin in the Treatment of Upper Limb Spasticity -- Mechanism of Action of BoNTs -- Concerns About Dosing -- Why Does BoNt Work For Spasticity? -- Case Report 1: Treatment to Improve Passive Function -- Case Report 2: Treatment to Improve Active Function -- Consensus Statements and Evidence Reviews -- Summary -- References -- Chapter 13: Guidance Techniques for Botulinum Toxin Injections: A Comparison -- Chemodenervation Agents -- Combined Neurolytic/Chemical Denervation Procedures -- EMG Guidance for Chemodenervation Procedures -- Electrical Stimulation Guidance for Chemodenervation Procedures -- Imaging-Based Guidance For BoNT Injections -- Chemodenervation Procedures Guided by More than One Technique -- Conclusions -- References -- Chapter 14: Anatomical Correlation of Common Patterns of Spasticity -- The Shoulder -- The Elbow -- The Wrist -- The Hand -- The HIP -- The Knee -- The Ankle and Foot -- References -- Chapter 15: The Role of Physical and Occupational Therapy in the Evaluation and Management of Spasticity -- Factors to Consider -- Clinical Evaluation -- Rehabilitation Goals -- Modalities -- Evidence for Combined, Multimodal Approach -- Summary -- References -- Chapter 16: Emerging Technologies in the Management of Upper Motor Neuron Syndromes -- Neuroimaging Technologies -- Emerging Treatments -- Conclusions -- References -- Chapter 17: Effects of Noninvasive Neuromodulation in Spasticity -- Transcranial Magnetic Stimulation -- Transcranial Direct Current Stimulation -- Trans-Spinal Direct Current Stimulation -- Summary -- References -- Chapter 18: Pharmacologic Management of Spasticity: Oral Medications -- Gaba Agonists -- Baclofen -- Benzodiazepine Derivatives -- Other Gaba Derivatives -- Tiagabine -- Vigabatrin -- Topiramate -- Central Alpha-Adrenergic Agents -- Clonidine -- Tizanidine -- Serotonergic Agents -- Cyproheptadine -- Cannabinoids -- Other Agents -- Cyclobenzaprine -- Orphenadrine -- Treatment Paradigms of Spinal Disorders Versus Cerebral Disorders -- References -- Chapter 19: Intrathecal Baclofen for Spasticity -- History of ITB Therapy -- ITB Infusion—Neurophysiologic Mechanism of Action -- Components of ITB Therapy -- Experience with Specific Patient Groups: Children -- Experience with Ambulatory Patients -- Summary -- References -- Chapter 20: Surgery in the Management of Spasticity -- Philosophy of Surgery for Spasticity -- History of Surgical Interventions For Spasticity -- Goals of Surgery for Spasticity -- Factors Important in the Decision-Making Process -- Myotendinous Surgical Techniques For Treatment of Spasticity -- Surgery Management of Specific Conditions -- The Role of Rehabi.
litation After Surgery for Spasticity -- Future Considerations in Surgery For Spasticity -- References -- Part IV: Evaluation and Management of Diseases With Spasticity -- Chapter 21: Diagnostic Evaluation of Adult Patients With Spasticity -- Upper Motor Neuron Syndrome -- Causes of Spasticity -- Conclusion -- References -- Chapter 22: Overview of Genetic Causes of Spasticity in Adults and Children -- Introduction -- Hereditary Spastic Paraplegias -- Genetic Heterogeneity in HSP -- Clinical Heterogeneity in HSP -- Autosomal-Dominant HSP -- Autosomal Recessive HSP -- X-Linked HSP -- Emerging Pathways in HSP -- Perspective -- References -- Chapter 23: Spasticity Due to Disease of the Spinal Cord: Pathophysiology, Epidemiology, and Treatment -- Definition and Scope of the Problem -- Pathophysiology -- Normal Motor Control -- Spasticity Measures -- Treatment -- Conclusion -- References -- Chapter 24: Spasticity Due to Multiple Sclerosis: Epidemiology, Pathophysiology, and Treatment -- Spasticity in Multiple Sclerosis -- Epidemiology -- Pathophysiology -- Negative Effects of Spasticity and Reasons to Treat -- Evaluating Spasticity -- Treatment -- Summary -- References -- Chapter 25: Poststroke Spasticity Management with Botulinum Toxins and Intrathecal Baclofen -- Principles of Management of Spasticity -- Pharmacological Management of Spasticity -- Cost-Effectiveness -- Conclusion -- References -- Chapter 26: Management of Brain Injury Related Spasticity -- Epidemiology -- Pathophysiology and Unique Aspects of TBI -- Acute Evaluation and Management of Post-TBI Spasticity -- Pharmacological Management of Post-TBI Spasticity -- Peripheral Injection-Guided Therapy -- Summary -- References -- Chapter 27: Management of the Cancer Patient with Spasticity -- Epidemiology -- Clinical Presentation -- Types of CNS Tumors -- Other Considerations -- Nonpharmacological Spasticity Management -- Pharmacological Treatment -- Focal Treatments -- Conclusion -- References -- Chapter 28: Evaluation, Treatment Planning, and Nonsurgical Treatment of Cerebral Palsy -- Definition of Cerebral Palsy -- Etiology and Epidemiology -- Clinical Presentations of CP -- Evaluation -- Treatment Planning -- Physical Treatments -- Oral Medications -- Chemodenervation -- Case Study -- Case Study -- References -- Chapter 29: Surgical Management of Spasticity in the Child with Cerebral Palsy -- Selective Dorsal Rhizotomy -- Intrathecal Baclofen -- Orthopedic Surgery -- References -- Chapter 30: Spasticity Management in Long-Term Care Facilities -- Prevalence of Spasticity in Long-Term Care Facilities -- Underdiagnosis of Spasticity -- Undertreatment of Spasticity -- Barriers to Diagnosis and Treatment -- Case Study: Intermediate Care Facility For Individuals With Mental Retardation (ICFMRS) and the Vanderbilt University Experience -- Improving Spasticity Care in Long-Term Care Facilities -- Conclusion -- References -- Chapter 31: Economic Impact of Spasticity and Its Treatment -- References.
